Table 1.
Combinations of screening and interventions for the control of meticillin resistant Staphylococcus aureus (MRSA) in patients on intensive care units
Screening | Screening method | Intervention | ||
---|---|---|---|---|
Patient group* | Timing | Procedure | ||
No screening | Conventional culture of clinical swabs only | MRSA positive | On result | Isolation or decolonisation (chlorhexidine) |
No screening | Conventional culture of clinical swabs only | All patients | Pre-emptively | Isolation or decolonisation (chlorhexidine) |
No screening | Conventional culture of clinical swabs only | High risk patients | Pre-emptively | Isolation or decolonisation (chlorhexidine) |
All patients | Conventional culture | High risk patients | Pre-emptively (amended on screen result) | Isolation† |
All patients on admission, and weekly thereafter | Conventional culture | MRSA positive | On result | Isolation or decolonisation (mupirocin) |
Chromogenic agar | MRSA positive | On 48 hour result | Isolation or decolonisation (mupirocin) | |
MRSA positive | On 24 hour result (amended on 48 hour result) | Isolation† | ||
Polymerase chain reaction | MRSA positive | On result | Isolation or decolonisation (mupirocin) | |
High risk patients on admission, and weekly thereafter | Conventional culture | MRSA positive | On result | Isolation or decolonisation (mupirocin) |
Chromogenic agar | MRSA positive | On 48 hour result | Isolation or decolonisation (mupirocin) | |
MRSA positive | On 24 hour result (amended on 48 hour result) | Isolation† | ||
Polymerase chain reaction | MRSA positive | On result | Isolation or decolonisation (mupirocin) |
In all strategies, if MRSA was recovered from a clinical specimen the patient was isolated or decolonised according to the specified intervention.
*MRSA positive patients are believed to be colonised or infected with MRSA based on clinical or screening swab result.
†Decolonisation not applicable.